da Silva Fernanda Bassan Lopes, Gomes Daniela Lopes, de Carvalho Kênia Mara Baiocchi
Nutrition Graduate Program of University of Brasilia, DF, Brazil.
Nutrition Graduate Program of University of Brasilia, DF, Brazil.
Nutrition. 2016 Nov-Dec;32(11-12):1250-3. doi: 10.1016/j.nut.2016.01.018. Epub 2016 Feb 19.
In this study, multivariate analyses was used to investigate factors associated with weight regain long after Roux-en-Y gastric bypass.
This retrospective study comprised 80 patients (88.8% female) with at least 24 mo of postoperative time. Weight regain was defined as an increase of at least 10% of the lowest postoperative weight. The following data were collected: demographic characteristics, eating behavior, food intake, diet quality measured by the Healthy Eating Index, level of physical activity, follow-up visit attendance, anthropometric history, and postoperative time. Multivariate logistic regression generated a controlled analysis, followed by calculation of the odds ratio (OR).
The mean postoperative time was 47.0 ± 18.0 mo. The mean pre- and postoperative body mass indexes were 49.8 ± 9.3 kg/m(2) and 33.6 ± 7.2 kg/m(2), respectively. Despite satisfactory postoperative weight loss, 23.7% of the patients regained weight. After controlling for confounders, only postoperative time (OR 1.08; P < 0.01) and Healthy Eating Index (OR 0.95; P = 0.04) remained associated with weight regain.
Patients with long-term obesity and poor diet quality were at high risk of weight regain. These results suggest the need of nutritional monitoring during the late postoperative period, paying special attention to eating patterns.
在本研究中，采用多变量分析来探究Roux-en-Y胃旁路术后长时间体重反弹的相关因素。
这项回顾性研究纳入了80例患者（88.8%为女性），术后时间至少为24个月。体重反弹定义为术后最低体重增加至少10%。收集了以下数据：人口统计学特征、饮食行为、食物摄入量、通过健康饮食指数衡量的饮食质量、身体活动水平、随访就诊情况、人体测量史以及术后时间。多变量逻辑回归进行了对照分析，随后计算比值比（OR）。
术后平均时间为47.0±18.0个月。术前和术后平均体重指数分别为49.8±9.3kg/m²和33.6±7.2kg/m²。尽管术后体重减轻情况令人满意，但23.7%的患者体重出现反弹。在控制混杂因素后，只有术后时间（OR 1.08；P<0.01）和健康饮食指数（OR 0.95；P=0.04）与体重反弹相关。
长期肥胖且饮食质量差的患者体重反弹风险较高。这些结果表明术后晚期需要进行营养监测，尤其要关注饮食模式。
